Anastasiadou Dimitra, Parks Melissa, Brugnera Agostino, Sepulveda Ana R, Graell Montserrat
Faculty of Information and Communication Sciences, Universitat Oberta de Catalunya, Barcelona, Spain.
Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain.
Eat Behav. 2017 Jan;24:74-80. doi: 10.1016/j.eatbeh.2016.12.005. Epub 2016 Dec 21.
High rates of comorbidity are found among eating disorder (ED) patients, which may negatively affect treatment outcome and prognosis. However, there is a shortage of studies in Spain using clinician administered interviews to assess rates of comorbidity among these patients, particularly in adolescents. This study aimed to evaluate Axis I psychiatric diagnoses in adolescent patients with an ED and to compare them with patients with a distinct disorder with adolescent onset, substance use disorder (SUD) patients. Considering that maternal psychological distress is another factor involved in ED prognosis, a secondary aim was to examine the relationship between patient's psychological variables and maternal distress (depression and anxiety). The cross-sectional study included 50 ED patients, 48 SUD patients, and their mothers. More than half of the patients received a diagnosis for a comorbid disorder. Internalizing problems were more common among EDs and externalizing disorders were the most common comorbidities among SUDs, similar to findings from other countries. Maternal distress was associated with higher levels of depression and symptom severity in patients. No differences in distress were found between mothers of patients with a comorbid diagnosis and those without. Elevated anxiety or depression in mothers did not increase the likelihood of patients having a particular primary diagnosis. In short, while both ED and SUD patients presented high rates of comorbidity, the types of comorbid diagnoses were specific to each group. Assessing for the presence of comorbid disorders and targeting maternal psychological distress may guide treatment interventions and improve patient prognosis.
饮食失调（ED）患者中存在高共病率，这可能会对治疗结果和预后产生负面影响。然而，在西班牙，缺乏使用临床医生进行的访谈来评估这些患者共病率的研究，尤其是在青少年中。本研究旨在评估患有饮食失调的青少年患者的轴I精神疾病诊断，并将其与患有青少年期起病的其他疾病的患者，即物质使用障碍（SUD）患者进行比较。考虑到母亲的心理困扰是饮食失调预后的另一个影响因素，第二个目的是研究患者的心理变量与母亲困扰（抑郁和焦虑）之间的关系。这项横断面研究纳入了50名饮食失调患者、48名物质使用障碍患者及其母亲。超过一半的患者被诊断患有共病。内化问题在饮食失调患者中更为常见，而外化障碍是物质使用障碍患者中最常见的共病，这与其他国家的研究结果相似。母亲的困扰与患者更高水平的抑郁和症状严重程度相关。共病诊断患者的母亲和无共病诊断患者的母亲在困扰方面没有差异。母亲的焦虑或抑郁程度升高并不会增加患者患有特定原发性诊断的可能性。简而言之，虽然饮食失调患者和物质使用障碍患者都呈现出高共病率，但共病诊断的类型因每组而异。评估共病的存在并关注母亲的心理困扰可能会指导治疗干预并改善患者预后。
